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Non-Fellowship regional anesthesia training and assessment: an international Delphi study on a consensus curriculum
  1. Alwin Chuan1,
  2. Bahaven Jeyaratnam1,
  3. Shah Fathil2,
  4. Leonardo HC Ferraro3,
  5. Aneet Kessow4,
  6. Yean Chin Lim5,
  7. Michael J O’Rourke6,7,
  8. Vrushali Ponde8,
  9. Julien Raft9,
  10. Arthur Segurado10,
  11. Suwimon Tangwiwat11,
  12. Alexandra Torborg12,
  13. Lloyd Turbitt13,
  14. Andrew K Lansdown14,
  15. Edward R Mariano15,16,
  16. Colin JL McCartney17,
  17. Alan JR Macfarlane18,
  18. Louis YH Mok19,
  19. Steven L Orebaugh20,
  20. Amit Pawa21,
  21. Santhanam Suresh22,
  22. J Balavenkat Subramanian23,
  23. Thomas Volk24,
  24. Glenn Woodworth25 and
  25. Reva Ramlogan17
  26. On behalf of Education in Regional Anesthesia Collaboration (ERAC) Group
  1. 1Department of Anaesthesia, South West Sydney Clinical School, Liverpool Hospital, University of New South Wales, Sydney, New South Wales, Australia
  2. 2Department of Anaesthesia, Gleneagles Hospital Medini Johor, Johor, Malaysia
  3. 3Anesthesia and Pain, Federal University of Sao Paulo, Sao Paulo, Brazil
  4. 4Department of Anesthesia, University of Cape Town, Rondebosch, South Africa
  5. 5Department of Anaesthesia & Surgical Intensive Care, Changi General Hospital, Singapore
  6. 6Department of Anesthesiology and Perioperative Medicine, Loyola University Medical Center, Maywood, California, USA
  7. 7Department of Anesthesiology, Edward Hines, Jr. VA Hospital, Hines, Oregon, USA
  8. 8Department of Anaesthesia, Hinduja Health Care Surgical and Research Centre, Mumbai, India
  9. 9Department of Anesthesiology, Institut de Cancerologie de Lorraine, Vandoeuvre-les-Nancy, France
  10. 10Department of Anesthesia, Hospital Sírio-Libanês, Sao Paulo, Brazil
  11. 11Department of Anesthesiology, Mahidol University, Salaya, Thailand
  12. 12Discipline of Anaesthesiology and Critical Care, University of KwaZulu-Natal, Durban, South Africa
  13. 13Department of Anaesthesia, Belfast Health and Social Care Trust, Belfast, UK
  14. 14Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
  15. 15Anesthesiology and Perioperative Care Service, VA Palo Alto Health Care System, Palo Alto, California, USA
  16. 16Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA
  17. 17Department of Anesthesiology and Pain Medicine, Ottawa Hospital, Ottawa, Ontario, Canada
  18. 18Department of Anaesthesia, Glasgow Royal Infirmary, Glasgow, UK
  19. 19Department of Anaesthesia and Intensive care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
  20. 20Department of Anesthesiology, University of Pittsburgh Medical Center-Southside, Pittsburgh, Pennsylvania, USA
  21. 21Department of Anaesthesia, St Thomas' Hospital, London, UK
  22. 22Department of Pediatric Anesthesiology, Ann and Robert H. Lurie Childrens Hopsital of Chicago, Northwestern University, Chicago, Illinois, USA
  23. 23Department of Anaesthesia & Perioperative Care, Ganga Medical Centre and Hospitals Pvt Ltd, Coimbatore, India
  24. 24Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany
  25. 25Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, Oregon, USA
  1. Correspondence to Dr Alwin Chuan, Department of Anaesthesia, South West Sydney Clinical School, Liverpool Hospital, University of New South Wales, Sydney, New South Wales, Australia; dr.chuan{at}


Background and objectives While there are several published recommendations and guidelines for trainees undertaking subspecialty Fellowships in regional anesthesia, a similar document describing a core regional anesthesia curriculum for non-fellowship trainees is less well defined. We aimed to produce an international consensus for the training and teaching of regional anesthesia that is applicable for the majority of worldwide anesthesiologists.

Methods This anonymous, electronic Delphi study was conducted over two rounds and distributed to current and immediate past (within 5 years) directors of regional anesthesia training worldwide. The steering committee formulated an initial list of items covering nerve block techniques, learning objectives and skills assessment and volume of practice, relevant to a non-fellowship regional anesthesia curriculum. Participants scored these items in order of importance using a 10-point Likert scale, with free-text feedback. Strong consensus items were defined as highest importance (score ≥8) by ≥70% of all participants.

Results 469 participants/586 invitations (80.0% response) scored in round 1, and 402/469 participants (85.7% response) scored in round 2. Participants represented 66 countries. Strong consensus was reached for 8 core peripheral and neuraxial blocks and 17 items describing learning objectives and skills assessment. Volume of practice for peripheral blocks was uniformly 16–20 blocks per anatomical region, while ≥50 neuraxial blocks were considered minimum.

Conclusions This international consensus study provides specific information for designing a non-fellowship regional anesthesia curriculum. Implementation of a standardized curriculum has benefits for patient care through improving quality of training and quality of nerve blocks.

  • regional anesthesia
  • education
  • ultrasonography
  • nerve block

Data availability statement

Data are available upon reasonable request

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Data availability statement

Data are available upon reasonable request

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  • Twitter @AlwinChuan, @Dr_M_ORourke, @LloydTurbitt, @TheLansdowns, @EMARIANOMD, @ajrmacfarlane, @amit_pawa

  • Contributors AC and RR were involved in conceptualizing the study. All authors contributed to the final study protocol. All authors were involved in inviting participants to commence round 1. BJ was data manager for the REDCap server. AC, RR, and BJ were involved in data synthesis. AC drafted the initial manuscript, and all authors revised and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests Alan Macfarlane: received consultancy fees from Intelligent Ultrasound. Amit Pawa: received honoraria from GE Healthcare, Sintetica UK, Pacira and Butterfly Net Inc. Have also consulted for B Braun Medical Ltd. All other authors declare no conflicts or competing interests.

  • Provenance and peer review Not commissioned; externally peer reviewed.